Ovarian cysts: distinguishing the physiological from the concerning

Ovarian cysts occur frequently in women of all ages and can be physiological, benign or malignant. As cysts often first present in primary care, it is important that GPs assess the cyst and determine appropriate follow up. Patient history, age, menopausal status and physical examination will help determine the risk of a concerning cyst and whether referral to a specialist is warranted. First-line investigations include transvaginal ultrasound and, in some cases, testing for cancer antigen 125 levels.